NCG050366_COMPLETE FILE - HISTORICAL_20170124

STORMWATER DIVISION CODING SHEET
RESCISSIONS.
PERMIT NO.
N,C Cy DSU 3
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ � O I q U I D�
YYYYMMDD

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NCDENR
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Division of Energy, Mineral and Land Resources
Land Quality Section / Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Received
Year
Month
I Day
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual" mean?
The person is either:
• the responsible corporate officer (for a corporation); RFC1=1\/1=n
• the principle executive officer or ranking elected official (for a municipality, state. federal or other public
agency); JAN 24 2017
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above. I)ENR.LAflD QUALITY
STORMWATER PERMITTNO
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
N I C I S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(or) Certificate of Coverage
N I C I G 1 p5 0 316, (p
cv"6�k LL-r-
1 U 4o1 W; r 131 vA Address
C 4.%ar 10+_ AIc_ 2SA73
City - State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://portal.ncdenr.oreweb/lr/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed: -;
n� Z
Previous legally responsible individual: V060% �
First MI Last Ll
r�
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit: 1 .,E' L _ A
First MI Last
Page l of 2
S W U-OW N E RAF F I L-25J u ly 2014

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
Pwnl±0.nA�
Title
11401 w mar 81Vd
Mailing Address
C 2 62-73
City State Zip
(7) 5 s - r Loa -±a;;or,, a aetpk, CoAA
'Telephone E-mail Address
Fax Number
5) Reason for this change:
A result of: PEmployce or management change
❑ Inappropriate or incorrect designation before
❑ Other
If o1her please explain:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
I. Tf e_n� A&A , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed. X
I A 94 r
Sig ature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call 919-707-9220 or visit the website at:
http://portal.nedenr.orvjweb/Ir/stormwater
Page 2 of 2
SW U-OWNERAFF I L-25July2014

Georgoulias, Bethany
From:
Georgoulias, Bethany
Sent:
Wednesday, December 17, 2014 4:44 PM
To:
[e-mail]
Cc:
Alexander, Laura
Subject:
RE: Stormwater Permit Renewal NCG050366
Attachments:
NCG050366_COC.pdf
Hi Brent,
Please see the attached COC. You probably got a confirmation email earlier too.
I used our old electronic COC website to generate this, and it prints the current date on the COC. That is the reason for
the December 17, 2014 effective date. If you go to this website:
http://portal.ncdenr.orci/web/Ir/stQrmwaterl20l3-gps
You will find the NCG050000 print package. That will contain a copy of the entire General Permit, as well as the technical
bulletin and monitoring forms. Please print that out for your site to use and reference.
If you have any other questions, please let us know!
Thanks,
Bethany
Bethany Georgoulias, Environmental Engineer
NCDENR / DEMLR / Stormwater Permitting Program
1612 Mail Service Center, Raleigh, NC 27699-1612
512 N. Salisbury Street, Raleigh, NC 27604
919 / 807-6372 (phone); 919 / 807-6494 (fax)
Website: http://portal.nedenr.orgZweb/ir/stonnwater
Li -moil cenrespowkace 10 raid, fivmr this address may be suhjecl to 1he North Carolina Public Records I,tir and may Ix, disclosed !o thirel parries.
From: [e-mail] [[e-mail]]
Sent: Tuesday, December 16, 2014 7:20 AM
To: [e-mail]
Cc: Georgoulias, Bethany
Subject: RE: Stormwater Permit Renewal and Overdue Permit Annual Fee - NCG050366 NOW NEEDS RENEWAL",
Bethany, can you check on the status of our permit. I was reviewing our documentation and found that I didn't have a
copy of our latest permit. If everything is up to date, can I get a copy (electronic version is fine) of the latest permit?
Thank you for your help!
Brent Levi
Quality Manager
Genpak
1001 Westinghouse Blvd
Charlotte, NC 28273

^ of wArF9Q
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� y
❑ `C
January 25, 2008
Mr. Daryl Slaughter
Genpak, LLC
11401 Wilmar Boulevard
Charlotte, NC 28273-6410
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins. Director
Division of Water Quality
Subject: General Permit No. NCG050000
Genpak, LLC — Charlotte Facility
COC No. NCGO50366
Mecklenburg County
Dear Mr. Slaughter:
In accordance with your application for a discharge permit received on December 27,
2007 we are forwarding herewith the subject certificate of coverage (COC) to discharge under
the subject state — NPDES general permit. This permit is issued pursuant to the requirements of
North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection Agency dated May 9, 1994 (or as subsequently
amended).
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality. The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other
federal or Iocal governmental permit that may be required.
Please note that the attached permit expires on April 30, 2008. Your COC will be
automatically renewed to cover the full 5 year term of the soon to be reissued permit. In the
interim you must abide by the terms of the expiring permit. Though they are not complete yet,
you will be able review the proposed general permit changes once they are drafted and posted at
http://h2o.enr.state.nc.us/su/pubiicnotice.htm.
If you have any questions concerning this permit please contact Robert Patterson at
telephone number [phone] ext. 360, or [e-mail].
Sir6MNAL SIGNED BY
BRADLEY BENNEfT
for Coleen H. Sullins
l,Z' hcamIina
Aalurally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: h2o.enr.state.nc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recyccled/10% Post Consumer Paper

COC No. NCG050366 ap
Mr. Daryl Slaughter
Genpak, LLC — Charlotte Facility
January 25, 2008
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG050000
CERTIFICATE OF COVERAGE No. NCGO50366
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Genpak, LLC
-is hereby authorized to discharge stormwater from a facility located at
Genpak, LLC — Charlotte Facility
11401 Wilmar Boulevard
Charlotte
Mecklenburg County
to receiving waters designated as Sugar Creek, a class C water in the Catawba River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, Il, III, IV, V, and VI of General Permit No. NCG050000 as attached.
This certificate of coverage shall become effective January 25, 2008.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 25t4 day of January, 2008.
ORIGINAL SIGNED BY
BRADLEY BENNETT
for Coleen H. Sullins., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

Re: NCG050366 - Genpack, LLC - Charlotte Facility
Subject: Re: NCG050366 - Genpack, LLC - Charlotte Facility
From: Michael Parker <[e-mail]>
Date: Wed, 16 Jan 2008 08:56:06 -0500
To: Robert Patterson <[e-mail]>
Robert,
I don't see any reason not to move forward with issuance of the COC.
Mike
Robert Patterson wrote:
Michael Parker - [e-mail]
Environmental. Engineer II
North Carolina Dept. of Environment & Natural Resources
Division of Water Quality
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Ph: [phone] Fax: [phone]
1 of 1 1/18/2008 7:16 AM